Short sleep duration and insomnia have been linked to higher pain and an increased risk of developing chronic pain, but relatively little research has examined the contribution of sleep disordered breathing (SDB) to pain. This study examined the unique contributions of SDB and insomnia to chronic pain. Patients who presented to the University of Florida Health Sleep Center for overnight polysomnography were invited to participate, provided they had no history of using positive airway pressure. Participants (N = 105) completed additional questionnaires about their sleep (Insomnia Severity Index) and pain (Medical College of Virginia Pain Questionnaire, pain locations, chronic pain diagnoses) before undergoing overnight polysomnography. They subsequently completed an online sleep/pain diary for two weeks. Physicians diagnosed 52.38% with obstructive sleep apnea (OSA) and 4.76% with insomnia, though 20.95% were classified as having chronic insomnia based on sleep diaries used for the study. In a hierarchical regression, polysomnography-measured total sleep time, but not measures of sleep fragmentation (apnea-hypopnea index, spontaneous arousals) or hypoxemia (SaO2 nadir), was related to pain. The majority of participants (80.00%) reported chronic pain, with musculoskeletal pain (28.57%) and chronic headaches (24.76%) being the most frequent. Although the likelihood of having chronic pain did not differ by sleep disorder, there was a significant difference in pain intensity; individuals with comorbid OSA/insomnia (12.38% of the sample) reported an average pain intensity that was 20 points (out of 100) higher than individuals with insomnia or no diagnosis and 28 points higher than those with OSA, controlling for participant sex (ps < .05). Thus, although polysomnography measures of SDB severity were unrelated to pain intensity, individuals with comorbid OSA/insomnia had the most severe pain.
|Advisor:||Robinson, Michael E.|
|Commitee:||Dotson, Vonetta, Ebner, Natalie, Pereira, Deidre, Robinson, Michael E.|
|School:||University of Florida|
|Department:||Clinical and Health Professions|
|School Location:||United States -- Florida|
|Source:||DAI-B 80/07/(E), Dissertation Abstracts International|
|Subjects:||Health sciences, Clinical psychology|
|Keywords:||Chronic pain, Insomnia, Obstructive sleep apnea, Sleep disordered breathing, Sleep fragmentation|
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